June 12, 2012: Status Epilepticus 2012
Dr. James J. Riviello, Jr., MD
NYU Langone, New York, NY
Table of Contents
Status Epilepticus: 2012 Pediatric Grand Rounds 06-12-2012
0:00:00
Objectives
0:00:32
Definition of Status Epilepticus (SE): World Health Organization Dictionary of Epilepsy
0:00:44
Duration of the "unvarying and enduring epileptic condition"
0:01:41
Operational Definition of SE (Lowenstein, Bleck, Macdonald): Epilepsia 1999;40:120-122
0:03:16
Operational Definition of SE (Lowenstein, Bleck, Macdonald): Epilepsia 1999;40:120-122
0:03:16
Mechanistic Definition
0:04:07
Pathophysiology of Sz/SE
0:04:32
Mechanistic Definition: Failure of the mechanisms that normally stop seizures
0:05:29
The Sz/SE: NCSz/NCSE Continuum (Clinical and EEG)
0:06:57
Classification of Status Epilepticus
0:08:00
Data from Practice Parameter Dx Assessment SE (2006)
0:10:13
Etiologies Status Epilepticus (n-1859); practice parameter
0:12:57
Clinical Stages of Status Epilepticus; Shorvon S
0:14:20
Timelines and a Time to Treat: concept of compensatory mechanisms
0:17:48
When is SE Refractory?
0:23:48
Pediatric SE: Mortality and Morbidity
0:25:17
Steps in Treatment process: 1) Identify Seizures 2) Treat Seizures. What are the Tx Goals?
0:27:04
Treatment SE: Supportive Measures, the A,B,C s
0:27:49
What other Studies Needed? To identify etiology or a complication
0:28:14
Current Practice EEG for SE
0:30:01
The Recognition of NCSE in Critical Care: Are there predisposing conditions?
0:31:55
Optimal Treatment for SE
0:32:39
Immediate Treatment: First-Line Tx
0:33:43
Subsequent Treatment aka: Second through Fifth-Line Tx
0:35:43
NCS Guidelines: 2012
0:35:55
Bleck TP. Continuum 2012
0:37:17
Texas Children's Hospital-approved evidence-based practice guidelines: Status Epilepticus
0:38:08
Texas Children's Hospital-approved evidence-based practice guidelines: Status Epilepticus
0:38:08
Fosphenytoin
0:38:46
Phenobarbital
0:40:21
Valporic Acid
0:41:05
IV VPA versus Pb in CSE following IV diazepam: Malamari et al; Eur J Ped nEURO 2012
0:42:15
Levetiracetam
0:43:05
Lacosamide
0:44:40
"Home Remedies" or No IV access
0:45:05
Respiratory Depression with Benzodiazepines (home remedies)
0:45:49
Buccal Midazolam versus Rectal Diazepam: McIntyre J et al. Lancet 2005
0:46:15
Wermeling DP
0:46:59
Toxicology/Ingestions: Practice Parameter: 3.6%
0:47:18
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Dr. Riviello of NYU Pediatrics talks about Status Epilepticus 2012.
 
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Jun 13, 2012 652 VA:06:12:7509:2012
 
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